Both Dr. Adams and Dr. Fauci acknowledged the emerging evidence about transmission and the importance of masks and changed their messages, advising individuals to wear face coverings while in public.45, 46
While likely uncomfortable for many leaders, communicating uncertainties and emphasizing the work being done to address them can help strengthen public support and compliance.32, 47 Identifying and investigating gaps in our understanding is core to the scientific process, and this should be communicated clearly. People may be more receptive to unknowns when they are presented as steps in the robust scientific process rather than the result of failures by authorities.32, 48
Be Credible
A novel pathogen presents a complex, dynamic situation for public health officials and health communicators. Information shared one day may be completely reversed the next as more evidence emerges; guidance can quickly become obsolete. The public can often be forgiving of perceived errors from authority figures. Maintaining credibility is driven heavily by not only being at the forefront and being correct, but also being honest and transparent, even when sharing difficult information. CERC emphasizes the importance of transparency and not shielding the public from information because of fears of panic or embarrassment.11, 17, 38
President Trump declared COVID-19 an emergency in the United States on March 13, 2020. In September, it came to light that he downplayed the threat of the virus in a March interview, and he said he did so because he was worried about creating panic.49 A week after the March interview, at a White House press briefing, he asserted that the number of cases would be close to zero in a few days.50 Experts suggested he had another option: calmly and accurately communicate to the American people about the risks related to the virus and preventive actions they could take to reduce their risk. When asked if he perhaps misled the public with these comments, he argued that he did so in order to reduce panic.51 He also asserted that the virus would disappear on its own, even as scientists argued that the pandemic would not be eradicated without widespread distribution of a COVID-19 vaccine.52 Withholding information from the public and communicating known falsehoods undermined President Trump’s credibility and damaged public trust.
As a leading health authority in the United States and globally, the CDC is seen as one of the most scientifically rigorous and trusted sources for health and disease guidance. With schools closed since March, school officials looked to the CDC for directions on reopening and in-person learning. When this guidance finally came in late July, only weeks before many schools would normally start, it was flagged as “very tough and expensive”53 by President Trump and others. Two weeks later, the CDC issued new guidance that was notably less strict than the original recommendations.53 This perceived bowing to political pressure, rather than relying on scientific rigor, was another blow to the CDC’s credibility.54
Ambiguous or contradictory guidance amplifies already stressful crises and increases risk. South Dakota Governor Kristi Noem described critical protective actions like wearing masks as optional at a large Fourth of July event and specifically stated social distancing would not be in place.55 This contradicted public health guidance and placed the onus on individuals to determine their own risk.
Trust is a critical antecedent to government legitimacy and credibility, which shapes citizens’ responses to government demands.56 Residents who perceive their public leaders as trustworthy are more likely to comply with government demands; this is particularly relevant to the COVID-19 crisis because an effective response depends on collective compliance of public health guidelines.57
Express Empathy
Crises inject a great deal of uncertainty, fear, and anxiety into people’s lives. Acknowledging these feelings can help build trust, calm anxiety, and restore order. The CERC manual suggests that empathy should be expressed early on in any messaging, because empathy is critical to create rapport. However, empathetic communication alone is insufficient. Authorities who publicly acknowledge the shared sacrifice and anxiety experienced by their communities but privately fail to abide by the same standards damage public trust and work against risk communication initiatives. Throughout the COVID-19 pandemic, the American people have been shown the full spectrum from apathy to empathy, and in some cases the empathy shown has been called into question by subsequent personal actions.
Political and public health leaders have drawn on personal experience with the disease—their own illness or that of loved ones, and the experiences of family and friends involved in caring for COVID-19 patients—and the challenges of restrictions on gathering, school closures, and other interventions, particularly leading up to the holiday season. Unfortunately, for every expression of empathy, we can find an example of indifference toward the struggling American public or a failure to follow through with appropriate actions. In March, Texas Lieutenant Governor Dan Patrick was criticized for asserting “there are more important things than living” after suggesting that senior citizens might be willing to die to save the economy and that some people need to take some risks to get the country back to normal.58 On school reopening, US Secretary of Education Betsy DeVos forcefully pushed for an accelerated school reopening, despite withholding necessary funding for safe operation as outlined by CDC recommendations. DeVos downplayed the risk of transmission and threatened to take away funding from schools that did not reopen.59 These statements trivialize the losses and struggles that so many Americans have experienced.
